AC 439(1) SOUTHHALL SOUT 17 BOROUGH OF SOUTHALL ANNUAL REPORT 7 OF THE Medical Officer of Health for the Year 1949 MARGARET A. GLASS, Medical Officer of Health BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1949 MARGARET A. GLASS, Medical Officer of Health THE COUNCIL OF THE BOROUGH OF SOUTHALL, 1949 Members of the Public Health Committee are denoted by an asterisk. HIS WORSHIP THE MAYOR *ALDERMAN E. B. HAMBLIN, J.P. Deputy Mayor: Councillor A. E. Lye. Aldermen: *Gardner, P. E. Hamblin, E. B. Hopkins, W. H. *Lowe, J. Luckett, F. H. Smith, F. G. Councillors: Bray, W. D. *Cavell, Mrs. I. *Cooper, Mrs. M. Culling worth, F. A. Dane, A. T. *Dormer, J. G. P. *Douglas, H. C. Haigh, J. Lockyer, G. F. Lye, A. E. *Marks, F. J. (Chairman Public Health Committee) Salmon, J. *Shepherd, A. H Steele, T. J. *Taylor, F. K. *Walker, F. C. *Ward, E. Ward, J. H. To the Mayor, Aldermen and Councillors of the Borough of Southall. MR. MAYOR, LADIES AND GENTLEMEN, 1 have the honour to present the 53rd Annual Report on the health and sanitary circumstances of the Borough for the year 1949. The health of the population continued to be good. The birth rate was 15.72, a reduction from 18.14 in 1948. This reduction was general throughout the country, but the birth rate for Southall was slightly lower than the birth rate for England and Wales which was 16.7. The death rate was 9.43. This had been decreasing steadily since 1945, but it rose in 1949, the corresponding rate in the year 1948 being 8.28. There was an increase in the number of deaths from heart disease and from cancer. A matter for satisfaction on the list of statistics of causes of death, was the reduction in deaths from suicide and other violence, and the absence of any deaths from road traffic accidents for the first time since 1943. The infant mortality rate rose from 29.1 in 1948, which was the lowest on record in the Borough, to 40.18 in 1949. Of the 35 deaths, twenty-seven took place during the first four weeks after birth and of these, twenty-five occurred following hospital confinement, one after confinement in a nursing home, and the other death was that of an unidentified infant found in the canal. No neo-natal deaths took place after confinement at home. There was a slight increase in the number of deaths from tuberculosis; 24 deaths were recorded as compared with 22 in 1948. The number of notifications of new patients suffering from this disease was 126 as compared with 127 in 1948. 3 The total number of infectious disease notifications in 1949 was 477 compared with a total of 1262 in 1948. This is a big drop and there appears to have been a smaller number of notifications of all infections with the exception of poliomyelitis. There were 14 cases of poliomyelitis and polioencephalitis; 5 had some residual paralysis requiring treatment, 7 were non-paralytic. There were two deaths from polioencephalitis. There was no relationship between the cases, except in one instance where two persons living in the same house were attacked simultaneously, and no ascertainable source of infection in any one. The numbers of inspections made for housing defects increased from 5102 in 1948 to 5788, and as a result of these inspections 838 defects of a lesser or greater degree were discovered. 754 of these dwelling houses were rendered fit either as a result of informal action or following statutory enforcement. The remainder were still under review at the end of 1949. The number of cases of overcrowding coming to the notice of the Public Health Department during the year was rather lower than in 1948, i.e., 50 new cases of statutory overcrowding compared to 70 in the previous year. A noteworthy and satisfying figure is that 70 cases of overcrowding were relieved by the rehousing of the overcrowded families during 1949, as compared with 54 in 1948. The Borough has been fortunate in that no outbreaks of food poisoning have occurred, and in 1949 there were only four notifications of individual cases of food poisoning. There are several large food factories in the Borough which require constant supervision, and the catering establishments of the Borough, with the exception of school meals canteens and hospital kitchens, have been surveyed. A considerable number of structural defects have been remedied and advice given with regard to the proper and clean handling of food for human consumption. Propaganda by posters or by talks to clubs, youth groups and workers in canteens has been continued. The experiment on the Irradiation of Upper Air in Schools, commenced in 1947 to investigate the usefulness of such a method in the attempt to reduce infectious disease incidence in highly populated buildings, was completed at the end of 1949, but the report of the Medical Research Council, which will give the results of the experiment, is not yet available. During a Civic Week held by the Southall Borough Council in July the Public Health Department staff arranged a display stand and took the opportunity to use this exhibition for hygiene propaganda purposes. It was arranged al.so that the Mass Radiography Unit should be in attendance during the whole of the Civic Week at the exhibition site in order that the general public, as well as school parties, factory workers, etc., could be X-Rayed. During the year also the Medical Research Council carried out a survey on the tuberculin sensitivity of 4,165 school children and adolescents as part of the scheme of investigation to be carried out throughout the country, prior to the initiation of B.C.G. vaccination against tuberculosis. Two stations were erected for the investigation of atmospheric pollution in the neighbourhood, and the first figures obtained seem to suggest that the air of Southall is remarkably free from heavy atmospheric pollution compared to that of most corresponding industrial areas. A long standing nuisance which has been a subject of constant investigation and observation by the Health Department for many years was abated during 1949. This was a tipping site known as Yeading Dump, used for the deposit of refuse from the Borough of Marylebone and St. Pancras. The site was not actually within the Borough boundary, but gave offence by reason of 4 foul smells, fly infestation and rat infestation at various times to the inhabitants of neighbouring property which was almost entirely situated in Southall. However, during the year other arrangements were made by the Borough Councils concerned for their refuse disposal, and for their tipping at Yeading to cease early in 1950. I should like to thank all the staff of the Health Department for their willing co-operation and loyal support during the year under review. I am, Your Worship, Ladies and Gentlemen, Medical Officer of Health. Manor House, Southall. 5 HEALTH DEPARTMENT STAFF lor the year 1949 Medical Officer of Health: Margaret A. Glass, B.Sc., M.B., Ch.B. (Glasgow), D.P.H. (Cantab.). Sanitary Inspection Staff: Chief Sanitary Inspector: R. W. McDonald, Cert. S.I.B., Cert. M. & F. Deputy Chief Sanitary Inspector: L. Mair, Cert. S.I.B., Cert. M. & F., R.S.I. Smoke Certificate. District Sanitary Inspectors: W. Bowles, Cert. S.I.B., Cert. M. & F. C. H. Sargent, Cert. S.I.B., Cerl. M. & F., (Resigned 12.4.49.) F. A. K. Streeter, Cert. S.I.B., Cert. M. & F., (Resigned 31.10.49.) E. J. Crosby, Cert. S.I.B., Cerl. M. & F., (Appointed 5.12.49.) J. H. Willis, Cert. S.I.B., Cert. M. & F., (Appointed 12.12.49.) Additional Sanitary Inspector: R. Stockley, Cert. S.I.B., (Appointed 24.10.49.) General Assistant: R. A. Dean. Clerical Staff: Senior Clerk: Mrs. K. Jones. Clerks, Shorthand-Typists: Miss W. M. Stratton. (Resigned 4.6.49.) Miss O. V. Tebby. (Appointed 20.6.49. Resigned 20.8.49.) Mrs. M. E. Colbourne. (Appointed 22.8.49. Resigned 30.11.49.) Mrs. P. M. Dix. (Appointed 31.10.49.) B. J. Tolworthy. (H.M. Forces 10.7 49.) K. Keegan. Miss J. S. Snow. (Appointed 19.9.49.) STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH. Area (acres): Land, 2,554.5. Water, 50. Total, 2,604.5. Population—Registrar-General's estimate (Mid 1949) 56,350 Number of inhabited houses according to Rate Book 14,354 Rateable Value £415 835 Sum produced by a penny rate £1,612.13s. 8d. The Council control the following parks and open spaces:— Southall Park 26 acres Recreation Ground 18 acres Manor House Grounds 2 acres Norwood Green 7.25 acres Wolf Fields 3.33 acres 6 Southall Municipal Sports Ground 20 acres Jubilee Park 11.13 acres Durdans Park 29.5 acres Viaduct Field 4.22 acres Swimming Bath Site 10.5 acres West Middlesex Golf Course 108 acres For general administrative purposes and for the main statistical purposes of this report, the district is divided into six wards with boundaries as detailed in previous annual reports. The majority of the houses in the district are occupied by good-class working people, chiefly engaged in the local lactories and workshops. These include food, jam and chemical works, engineering, hosiery, paint, dye, and wood works, laundries, etc. There are no trades carried on which are at present scheduled as offensive trades. BIRTH AND DEATH RATES Whole Distric t Total deaths, 531. (Males, 271; Females, 260.) Crude Death Rate, 9.43. For extracts from vital statistics and causes of deaths, sec Appendix, Tables I and II. Deaths. The death rate which has been decreasing over the last few years rose from 8.28 in 1948 to 9.43 in 1949. The corresponding rate for the whole country was 11.7. Heart disease and cancer were again the principal causes of death and both showed a considerable increase on the 1948 figures. Although the incidence of poliomyelitis and polioencephalitis was comparatively low in the district, there were two deaths from polioencephalitis. One was a schoolboy aged 16, who had taken part in school sports shortly before his illness, but the other case, a young married man, had no history of strenuous exercise or other ascertainable reason why the attack should have been so virulent. It is pleasing to note that during the year there were no deaths from road accidents in the Borough. The total number of deaths registered during 1949, of persons belonging to the district and dying within the district, at all ages and from all causes, was 276 (males 125 and females 151). For statistical purposes it is necessary to add to this figure the deaths of persons ordinarily resident in the district who died in various London Hospitals, the Hillingdon County Hospital, other Middlesex County Hospitals and elsewhere outside the district. These "outside" deaths were 255 in number (males 146 and females 109). The total number of deaths, therefore, belonging to the district was 531. The deaths of non-Southall residents in the St. Bernard's Hospital (not included in the above figures) numbered 151 (male 51 and females 100.) For the distribution of deaths in the various Wards, see Appendix, Table III, and for the comparison of general birth and death rates and rates of maternal mortality, see Appendix, Table IV. Births and Birth Rate. (Figures for 1948 are given in brackets.) The total number of registered births in the district (as notified under the Births and Deaths Registration Act) was 364 (351). The total number of live births belonging to the district, whether occurring within or outside the district was 871 906). The illegitimate live births were 39 (53). There were 14 stillbirths (23) and these were all legitimate. 7 The birth rate for Southall is still declining. It has fallen every year since 1946 and is 15.72 for 1949 compared with 18.14 in 1948. The corresponding rate for the whole of England and Wales in 1949 was 16.7. In view of the housing situation in the district it is a matter rather more for satisfaction than otherwise that the birth rate should be low. It is unfortunate that persons who are sub-tenants or who are occupying furnished accommodation in the district very often find themselves in danger of complaints, difficult personal relationships, and sometimes eviction on the arrival of a new infant, and it is not easy for such families to obtain other accommodation. Infant Mortality. It is very disappointing to note that during the year 1949 the infant mortality rate has risen from 29.1 to 40.18, this corresponds with a national rate of 32. Examination of the details of these deaths shows that 34 deaths out of 35 occurred in nursing home or hospital, and one was that of an unidentified infant found in the canal. Only 6 of these deaths were due to congenital malformations and, therefore, unpreventable in the light of our present knowledge. The number of premature infants born in 1949 was 33, of whom 24 survived to the end of one month. Maternal Morbidity. During the year three cases of puerperal pyrexia were notified. There was one maternal death, but no death associated with abortion. Scabies Clinic. The total number of attendances at the Clinic for treatment of scabies and other skin conditions during 1949 was 1,685. Details of the cases were as follows:— Scabies First Visit 71. Re-attendances 208. Total 279 Other skin conditions „ „ 205. „ 717. „ 922 Verminous heads „ „ 251. „ 233. „ 484 Baths (395 treatment baths; 371 ordinary) „ 766 Total attendances for all purposes 2,056 Total attendances for treatment 1,685 Although the total attendance numbers for all purposes is higher than in 1948, the attendances for treatment at the Cleansing Station decreased in 1949. The total number of treatments, 1,685, compares with a total number of 1,858 in 1948. It is probable that the decrease in scabies is actual and shows a satisfactory state of skin cleanliness in the Borough, but the figure for verminous heads is open to query, as the number of cases referred from the schools for home treatment is increasing over the number sent to Crosby House. If these cases are brought to the Cleansing Station it is very often possible to trace evidence of infection amongst elder members of the family who might escape detection otherwise for a considerable amount of time, that this is possible is shown by the number of cases attending the Cleansing Station who are suffering from a heavy degree of infestation usually with considerable secondary infection of the scalp, and sepsis. It is usual in those cases to obtain the attendance of other members of the families concerned who have some degree of infestation and the work of clearing the whole family is then carried out satisfactorily. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES There was a considerable drop in the number of infectious disease notifications during 1949, principally caused by the comparatively small number of measles notifications—194 as compared with 825 in 1948. This is in accordance with the biennial incidence of measles epidemics, although I noted in my Annual Report 8 for 1948 that there was some indication of an alteration in the biennial fluctuation, since the figure in 1947 (334) was higher than usual during a quiet year for measles. The reduction in the scarlet fever incidence from 110 in 1948 to 74 in 1949 was satisfactory. The higher incidence of poliomyelitis and polioencephalitis was disappointing as the Borough has had a good record for this disease, but out of the fourteen cases seven were non-paralytic. One of the two deaths from polioencephalitis occurred in a grammar school boy of 16, who had been training for school sports and it seems likely that over-exertion may have played its part in reducing this boy's resistance to the infection. The other case who died was a young man, one of whose relations living in the house was an employee of a civil airways corporation, travelling to various places abroad. An interesting point about this case was that this relative had two years previously been in close contact with a case of poliomyelitis, but in the present state of knowledge concerning this disease it was impossible to complete any definite investigations which might relate to this fact the illness occurring in this house in which, as well as the case which died, there was another simultaneous case of paralytic poliomyelitis. Provision of Antitoxin. The Council provided antitoxin free to local practitioners for cases of diphtheria in the district. The Ministry of Health also sanctioned the supply of tetanus antitoxin by the Council to local practitioners if such should be required. Diphtheria and tetanus antitoxins were obtainable at the Health Department during office hours. Disinfection. In cases of infectious disease, rooms, clothing, etc., were disinfected—rooms by sealing and fumigating with formalin or a formalin preparation; clothing, bedding and other infected articles by removal for disinfection in the Council's disinfector at Salisbury Road Depot. Table a List of premises, articles, etc., disinfected during the year:— Rooms 35 Eiderdowns 1 Beds 59 Pillows 2 Blankets 9 Sheets 3 Books 92 Articles of clothing 6 Quilts 1 Sacks 250 Two mattresses were destroyed. Cancer. It will be seen by the table of causes of death (page 22) that in 1949 100 cases (46 males and 54 females) died from cancer. (See Appendix, Tables VII and VIII.) Special Infectious Diseases. Smallpox (Variola). No patients with smallpox, but 3 contacts of cases of smallpox occurring on board ship, were notified to the Department from the Port Authorities during the year. The contacts were kept under supervision for the requisite period, but no illness developed. Scarlet Fever (Scarlatina). The number of notifications received during the year was 74, as compared with 110 for the previous year. Diphtheria. No cases of diphtheria were notified to the Health Department. Ophthalmia Neonatorum. No cases of Ophthalmia Neonatorum were notified during the year. Acute Poliomyelitis and Polioencephalitis. Eight cases of poliomyelitis and six cases of polioencephalitis were notified in the Borough during the year. Five cases were left with residual paralysis and further treatment by physiotherapy was arranged for these cases. There were two deaths from polioencephalitis. Notifiable Diseases during the Year. For the incidence of various infectious diseases, notified during the year, under age groups and locality, see Appendix, Tables IX and X. Infectious Disease Visits. During the year, the health visitors paid 326 visits with reference to cases of infectious disease. The total number of children examined by the Health Visitors in the schools was 125. Tuberculosis. Pulmonary Tuberculosis. The number of new cases notified during the year was 126. Other Forms of Tuberculosis. The number of new cases notified during the year was 10. Of the total notifications 28 were received from institutions, (Counly Council hospitals 3, general hospitals 25.) Deaths from Tuberculosis. Tuberculosis of the respiratory system, 23; other forms, 1. For details of new cases notified and deaths in 1949, see Appendix, Table XI, and for the occupations of new cases see Appendix, Table XII. Public Health (Prevention of Tuberculosis) Regulations, 1925. Public Health Act, 1936, Section 172. Action under these powers was not necessary during the year. Irradiation Experiment. Throughout 1949 the experiment on the control of the spread of infectious diseases amongst children by means of Irradiation of the Upper Air in classrooms and school halls continued It was decided by the Medical Research Council that an end would be made to the experiment in December, 1949, and that statistics of, and reports on, the results of the investigation could only be published after the whole period of work had been surveyed. This report is not yet published and consideration of it will have to be upheld until the next Annual Report. National Assistance Act, 1948—Section 47—Removal to suitable premises of persons in need of care and attention. 8 cases of complaint of old people said to be living in such bad conditions as to be in need of care and attention were received during 1949. All of these cases were investigated and means found to alleviate their circumstances by co-operation with the Home Helps Service Department and Welfare Department of the County 10 Council, with the Almoners of the local hospitals, and with some of the Voluntary Associations. No cases were removed from their homes by statutory action under the above Act. Health Propaganda. Propaganda by the spoken word continued throughout the year in factories, canteens, Youth Organisations, adult associations and to small groups whenever opportunity arose. Propaganda was also carried out by poster exhibits, and the local cinemas displayed a short film on poliomyelitis called "His Fighting Chance" during the early summer before notification of poliomyelitis had become heavy throughout the country. During the Southall Borough Council Civic Week the Public Health Department demonstrated to the members of the public attending, various details of the work carried out by the Department, with advice on problems put forward during the Week, and information with regard to obtaining the help of the Department in any case of nuisance or sanitary problem. ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT. Nine establishments were inspected for licence under this heading and all were found satisfactory for the purpose which was intended. Details are as follows:— Purpose No. of Licences Massage only 1 Chiropody only 3 Massage, Chiropody and Electrical Treatment 1 Massage and Electrical Treatment 3 Chiropody and Electrical Treatment 1 MEDICAL EXAMINATION OF BOROUGH COUNCIL EMPLOYEES During 1949 a total of 67 employees received medical examinations. Fifty-six were examined with regard to suitability for employment on the Council's permanent staff. Three were examined for entry in the Council's Sickness Pay Scheme. Eight, reaching completion of their sickness Pay entitlement, received special medical examinations and reports were made to the appropriate Committees of the Council. SANITARY CIRCUMSTANCES OF THE BOROUGH Water Supply and Water Services. Water is supplied to nearly the whole of the district by the South-West Suburban Water Company. The Metropolitan Water Board supplies a small area in the southern part of the district, and the Rickmansworth and Uxbridge Valley Water Company a small area in the northern part. The supply is satisfactory both in quality and quantity. Sampling: One sample was taken during the year and found to be satisfactory. Reports on sampling carried out by the Metropolitan Water Board are issued from time to time. Number of houses supplied from public water mains 14,354 % of houses supplied from public water mains 100% Number supplied direct to houses 14,341 Number of standpipes on mains 13 Sanitary Inspections of the District. The total number of inspections of premises made during the year in connection with the work of the Sanitary Inspectors was 9,427, an increase on the corresponding figure for 1948 which was 8,181. Table XIII shows an analysis of the number and nature of such inspections. 11 Eradication of Bed Buys. Table B. Statistics for the year:— (a) Number of Council Houses (1) found to be infested 14 Total: 34 (2) disinfested during the year 14 (b) Number of other houses (1) found to be infested 20 (2) disinfested during the year 20 Canal Boats. Visits were paid to the canal and 14 boats were inspected. The condition of both boats and occupants was satisfactory. There were no complaint notices issued by other authorities. Mortuary and Post-mortem Room. The mortuary, situated in Havelock Road, provides adequate accommodation for the Borough. Six bodies were deposited in the mortuary during the year. Factories Act, 1937. The following tables give details of the work done in connection with the factories and outworkers in the Borough:— INSPECTIONS Factory Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Non-Mechanical 8 15 Nil Nil Mechanical 185 124 5 Nil Totals 193 139 5 Nil DEFECTS FOUND Particulars Number of cases in which defects were found Found Remedied Referred Number of cases in which Prosecutions were instituted To H.M. Inspector By H.M. Inspector Want of cleanliness — - — — - Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage or floors - — — — - Sanitary Conveniences— (a) Insufficient 2 2 - 1 - (b) Unsuitable or defective 3 1 — 1 — (c) Not separate for sexes — — - - — Other offences against the Act (not including offences relating to outwork) - - - - - Totals 5 3 — 2 — 12 OUTWORKERS SECTION 110 SECTION 111 Nature of work No. of outworkers in August List required by Section 110 (1) (c) No. of Cases of Default in sending Lists to the Council No. of Prosecutions for failure to supply Lists No of Instances of Work in Unwholesome Premises Notices served Prosecutions Wearing apparel making etc. 14 — — — — Petroleum and Carbide. During the year 58 applications for licences to store petroleum were granted, and 4 applications were granted for licences to store carbide of calcium. Celluloid and Cinematograph Films Act, 1922. There are 2 licences in force for the purpose of stripping and making celluloid solution from cinematograph films of recent construction. Housing. Two hundred and ninety-six investigations revealed 50 cases of overcrowding (Housing Act, 1936). Other cases of overcrowding were given individual attention and special recommendations for medical reasons. Work is continuous on overcrowding review. For statistics see Table XIV in the Appendix. The one case of recurrence of overcrowding was a house lodging itinerant labourers. Administration of the Shops Acts. Headway was made into arrears of routine work. Classified trade lists were prepared and trend was established towards general conformity with the requirements of the Shops Acts. Kettles and gas rings were being replaced by wash-basins and sanitary accommodation was given better lighting and ventilation. Action in respect of certain premises is retarded by defects in original planning. Markets. The only market held in Southall is a small weekly one for the sale of horses, pigs, poultry and other liveslock. This is kept under supervision. Action was taken to secure the regular removal of manure. INSPECTION AM) SUPERVISION OF FOOD Milk. During 1949 new Regulations were issued by the Ministry of Food with regard to the designation of milk and its supervision. Control of premises for pasteurisation of milk was transferred from the local authority to the Food and Drugs Authority (in this area, Middlesex County Council). A new Special Designation (Sterilised) Milk was introduced, and the special designations to be used after the 1st October, 1949, were "Pasteurised," "Sterilised," "Tuberculin Tested (Pasteurised)," "Tuberculin Tested (Sterilised)" and "Tuberculin Tested." All licences authorising the use of a special designation were to be issued by the Food and Drugs Authority. Other important points in the new Regulations were:— (1) No fees to be payable in respect of dealers' licences. (2) A licence to be issued in respect of every premises used for the sale of milk, i.e., an individual distribu tor may not have one licence to covcr any number of shops. 13 (3) Provision now to be made for all designated milk to be kept separate from non-designated milks or milks with other designations. (4) One Regulation extends the powers of the Medical Officer of Health to take action in cases of suspected or confirmed infectious diseases associated with the sale of milk. The designations "Accredited' and "Standard" were permitted for a time, but are to be excluded from the list of designations after five years from the passing of the Act. After 1st October, 1949, 9 dealers' licences were issued in accordance with the Regulations. No action was required to be taken regarding infectious diseases associated with the sale of milk. Licences: The following licences under: (1) Milk (Special Designations) Order, 1936 (2) Milk (Special Designations) (Raw Milk) Regulations, 1949, and Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, were issued: (1) (2) for the sale of Tuberculin Tested Pasteurised 2 — for the sale of Tuberculin Tested Milk 10 — for the bottling of Tuberculin Tested Milk 1 — for the sale of Accredited Milk — — for the sale of Pasteurised Milk 13 — for the sale of Sterilised Milk — 9 for Pasteurisation 1 — Supplementary Licences 7 19 Totals 34 28 Sampling: Fifty-eight samples of milk, designated and non-designated (including one empty bottle) were sent during the year for bacterial count. The examinations are carried out by the Public Health Laboratory Service. Food Sampling: The chemical or bacteriological analyses of 191 food samples taken during the year were carried out by the Public Health Laboratory Service. The Pood and Drugs (Adulteration) Act is administered by the County Council. Better liaison was established with the Middlesex County Council with regard to the provision of information concerning sampling under the Pood and Drugs Act, 1938. Sixty-five of these specimens were ice-cream samples, covering 17 makes of ice-cream, and following bacteriological analysis the ice-creams were graded as follows:— I-31 II-28 III-3 IV-3 65 Food Inspections; Inspections are made of the carcases of slaughtered animals at St. Bernard's Hospital (L.C.C.) Slaughterhouse and pig clubs, and of premises where meat and other foods are sold or prepared for sale. There is no registered slaughterhouse or public abattoir in the district, and most of the meat supplied comes from the Ministry of Pood Distribution Centre. 14 FOOD INSPECTIONS Total Inspected (lbs) SOUND UNSOUND Total (lbs.) Stock (lbs.) Production (lbs.) Consumption (lbs.) Total (lbs.) Animal Feeding (lbs.) Byeproducts (lbs.) Destruction (1bs.) Canned 138560 7060 663 664 5733 131500 107360 396 23744 Raw 85081 35337 359 — 34978 49744 46377 1695 1672 Totals 223641 42397 1022 664 40711 181244 153737 2091 25416 CATERING ESTABLISHMENTS To the Public Health Committee at its meeting on the 5th July, 1949, there was presented a report in detail of action taken under Sections 39 and 89 of the Public Health Act, 1936 and Section 13 of the Food and Drugs Act, 1938. Points noteworthy from this report are:— (1) In the main shopping centre (Broadway) response to informal action was prompt to improve washing facilities and closet accommodation. (2) Two premises discontinued trade. (3) Five premises complied completely with formal notices under the statutes quoted. (It is satisfactory to record that licence and supply difficulties were resolved by liaison between the Ministry of Works and the Public Health Department.) (4) Sewer connections of three 25-year-old wooden structures were still proving difficult because of:— (i) Depth of main sewer under trunk highway. (ii) Restricted space at rear of the premises. (5) A gratifying response from licensed premises in better planned compliance with Section 89 of the Public Health Act, 1936. Publicity took the form of direct consultative relations with the Chamber of Trade on general problems and direct supervision at the work benches of local food factories where products are sampled weekly for examination by the Public Health Laboratory Service. The improvements asked for were based on the original byelaws adopted by the Council under Section 15 of the Food and Drugs Act, 1938. RODENT CONTROL Local policy may be recorded as follows:— (1) No "agreements" exist between the Council and local business premises. From the date when this work became the responsibility of the Council, it has been considered inadvisable that local food factories should, so to say, contract out of their legal obligation to keep these premises free from rodent infestation or invasion. 15 The managements of local food factories, and other business premises, instead submit to the Public Health Department measures proposed by their pest contractors; these are indicated on plan, and the work is supervised. (2) Private dwellings are treated free of cost. (3) Sewer treatments are carried out to routine; sewers in one ward (Hambrough) remaining positive. More work may have to be done on baiting inspection chambers in the area still within private curtilage showing "takes." ATMOSPHERIC POLLUTION In February, 1949, arrangements were made for two observation points for the estimation of Sulphur Dioxide by the Lead Peroxide Method (cowl covered) in the Borough. (1) North: Expected contaminants from industrial concentration in the south-west; one mile distant. (2) South: Isolated from industrial contaminants. Average results over six months' trial were 49.8 (North) and 55.4 (South) indicative of a non-industrial area. To commence 1950; a Deposit Gauge and two lead peroxide points (louvered) are to be established. 16 APPENDICES EXTRACTS FROM VITAL STATISTICS Table 1 Total Male Female Comparative figures for 1948 Live Births Legitimate 832 432 400 943 Illegitimate 39 22 17 53 Stillbirths- Legitimate 13 3 10 | 23 Illegitimate 1 - 1 Deaths 531 273 258 465 Birth rate (live and stillbirths) per 1,000 of the estimated population 15.72 18.14 Stillbirth rate per 1,000 total (live and still) births 15.82 23.10 Crude death rate per 1,000 of the civilian population 9.43 8.28 Deaths from Puerperal Causes (Headings 29 and 30) of the Registrar-General's Short List):— Rate per 1,000 total (live & still) Deaths births No. 29. Puerperal sepsis — — | 2.01 No. 30. Other puerperal causes — — Total — — Death rate of infants under 1 year of age:— All infants per 1,000 live births 40.18 29.12 Legitimate infants per 1,000 legitimate live births 40.87 27.57 Illegitimate infants per 1,000 illegitimate live births 25.64 2.01 Deaths from cancer (all ages) 100 84 Deaths from measles (all ages) — 1 Deaths from whooping cough (all ages) 2 — Deaths from diarrhoea, etc. (under 2 years of age) 4 4 18 Causes of Deaths, 1949. Table II Male Female Total 1949 Total 1948 1. Typhoid fever, etc – – – – 2. Cerebrospinal fever – – – – 3. Scarlet fever – – – – 4. Whooping cough 1 1 2 — 5. Diphtheria — – — — (J. Tuberculosis-Respiratory 10 13 23 17 7. Other tuberculosis 1 — 1 5 8. Syphilitic diseases — 2 2 2 9. Influenza 2 — 2 — 10. Measles — — — 1 11. Ac. poliomyelitis and polioencephalitis 2 – 2 – 12. Ac. inf. encephalitis — — — — 13/16. Cancer (all forms) 40 54 100 84 17. Diabetes 1 3 4 1 18. Intra-cran. vase, lesions 20 29 49 58 19. Heart disease 51 70 121 106 20. Other circulatory diseases 13 10 23 23 21. Bronchitis 29 8 37 32 22. Pneumonia (all forms) 19 14 33 27 23. Other respiratory diseases 5 1 6 3 24. Ulcer of stomach or duodenum 4 — 4 5 25. Diarrhoea, etc. (under 2 years) 4 — 4 4 26. Appendicitis 2 2 4 — 27. Other digestive diseases 9 7 16 4 28. Nephritis 5 3 8 4 29. Puerperal sepsis — — — — 30. Other maternal causes — 1 1 2 31. Premature birth 1 2 3 6 32. Congenital malformations, birth injuries, infant diseases 19 5 24 13 33. Suicide 1 — 1 5 34. Road traffic accidents — — — 0 35. Other violence 9 6 15 22 30. All other causes 19 24 43 35 Total deaths 273 258 531 465 Deaths in Wards. Table III WARD Male Female Total Waxlow Manor 39 26 65 Northcote 26 43 69 Hambrough 45 53 98 Dormers Wells 43 53 96 Glebe 73 49 122 Norwood Green 45 36 81 Total 271 260 531 19 Table iv Vital Statistics compared with other Areas. BIRTH-RATES. CIVILIAN DEATH-RATES, ANALYSIS OK MORTALITY, MATERNAL DEATH-RATES, AND CASE-RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1949. (England and Wales, London, 126 Great Towns and 148 Smaller Towns.) (Provisional Figures based on Weekly and Quarterly Returns.) England and Wales 126 CountyBoroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census) London Administrative County Southall Rates per 1,000 Civilian Population BIRTHS: Live 16.7 18.7 18.0 18.5 15.47 Still 0.38 0.47 0.40 0.37 0.25 DEATHS: All causes 11.7 12.5 11.6 12.2 9.43 Typhoid and paratyphoid fevers 0.00 0.00 0.00 0.00 0.00 Pneumonia 0.51 0.56 0.49 0.59 0.59 Smallpox 0.00 0.00 — – – Whooping Cough 0.01 0.02 0.01 0.01 0.04 Diptheria 0.00 0.00 0.00 0.00 0.00 Influenza 0.15 0.15 0.14 0.11 0.04 Tuberculosis 0.45 0.52 0.42 0.52 0.43 Acute poliomyelitis and polioencephalitis 0.01 0.02 0.02 0.01 0.04 NOTIFICATIONS (corrected) Smallpox 0.00 0.00 0.00 0.00 Scarlet fever 1.63 1.72 1.83 1.46 1.31 Diphtheria 0.04 0.05 0.04 0.07 — Typhoid fever 0.01 0.01 0.01 0.01 — Erysipelas 0.19 0.20 0.19 0.17 0.09 Pneumonia 0.80 0.91 0.65 0.55 0.89 Measles 8.95 8.91 9.18 8.54 3.45 Cerebro-Spinal Fever 0.02 0.03 0.02 0.02 – Whooping Cough 2.39 2.44 2.39 1.70 2.24 Paratyphoid Fever 0.01 0.02 0.01 0.01 — Acute poliomyelitis 0.13 0.13 0.12 0.18 0.14 Acute polioencephalitis ... 0.01 0.01 0.02 0.0 1 0.11 Rates per 1,000 Live Births Deaths under 1 year of age 32 37 30 29 40 Deaths from Diarrhoea and Enteritis under 2 years of age 3.0 3.8 2.4 1.7 4.59 Rates per 1,000 Total (Live and Still) Births NOTIFICATIONS (corrected) 6.31 8.14 5.30 6.82 6.78 Puerperal fever Puerperal pyrexia 20 MATERNAL MORTALITY (England and Wales) Per 1,000 Live and Stillbirths Abortion with Sepsis Abortion without Sepsis Puerperal Infections Other 0.11 0.05 0.11 0.71 ABORTION—MORTALITY PER MILLION WOMEN AGED 15-45 (England and Wales) With Sepsis Without Sepsis 8 4 Monthly Registration of Births. The monthly registration of births classified as to Wards is given in the following: table:— TABLE V Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total January 4 2 4 3 4 3 20 February 2 5 2 1 6 2 18 March 3 3 2 1 7 2 18 April 4 4 3 8 5 2 26 May 5 1 1 6 5 2 20 June 7 1 4 5 2 2 21 July 1 5 3 8 7 4 28 August 4 3 1 5 2 2 17 September 3 3 3 1 7 1 18 October 2 5 3 6 4 4 24 November 1 G 5 6 4 3 25 December 7 2 2 6 7 6 30 Total 43 40 33 56 60 33 265 TABLE VI Certified Cause of Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 1-3 months 3-6 months 6-9 months 9-12 months Total deaths under 1 year 1 2 – 2 5 1 1 – 1 S Congenital malformations, etc. 4 — – — 4 1 1 – – 6 Gastro-enteriitis, diarrhoeea, etc. — — – — — 1 1 1 – 3 Prematurity 8 1 – 1 10 – — – – 10 Asphyxia due to misadventure – – – – – – – – – – Asphyxia (Atelectasis) 3 — – — 3 – — – – 3 Birth Injury 5 — – – 5 – – – – 5 Totals 21 3 – 3 27 3 3 1 1 35 Live Births. Legitimate 832 Illegitimate 39 Infant Deaths. Legitimate 34 Illegitimate 1 21 TABLE VII DEATHS FROM CANCER Year Male Female Total Estimated Population Hate per 1,001) Population 1926 12 11 23 32,870 0.69 1927 13 13 26 33,480 0.77 1928 18 27 45 35,340 1.27 1929 12 10 22 35,370 0.62 1930 17 29 46 37,560 1.22 1931 20 28 48 39,280 1.22 1932 22 23 45 41,530 1.08 1933 23 28 51 44,780 1.13 1934 22 27 49 46,693 1.04 1935 30 27 57 48,270 1.18 1936 22 30 52 49.550 1.05 1937 42 28 70 51,560 1.35 1938 27 30 57 52,400 0.51 1939 33 41 74 52,430 1.41 1940 28 36 64 51,670 1.23 1941 34 37 71 50,280 1.41 1942 34 38 72 50,350 1.43 1943 51 46 97 49,730 1.95 1944 37 32 69 48,970 1.41 1945 39 44 83 49,880 1.88 1946 40 54 94 54,440 1.64 1947 45 32 77 56,240 1.36 1948 48 36 84 56,130 1.49 1949 46 54 100 56,350 1.77 The following table shows the age distribution of the cancer deaths:— TABLE VIII AGES AT DEATH IN CANCER CASES AGE 0-15 15-30 30-40 40-50 50-60 60-70 70-80 80+ Total Male – – 2 7 10 13 10 4 46 Female — — 1 7 9 12 19 6 54 Total – – 3 14 19 25 29 10 100 2 2 The following table shows the various infectious diseases (other than tuberculosis) notified during the year and also their age incidence:— TABLE IX NOTIFIABLE DISEASES DURING THE YEAR (OTHER THAN TUBERCULOSIS) Diseases Ages Total cases notified Deaths Under 1 year 1 to 2 2 to 3 3 to 4 4 to 5 6 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 65 65 and over Cerebro-spinal fever – – – – – – – – – – – – 1 — Dysentery- — 1 – – – 1 – – — 1 3 – 6 – Erysipelas — – – – – — – – — 4 1 – 5 – Food Poisoning – – – – – 2 – – – – – – 4 – Measles 5 37 3S 31 23 47 3 3 3 2 1 1 194 – Pneumonia 1 1 2 1 1 8 2 — 3 6 18 7 50 33 Polioencephalitis — — — — 1 — 1 1 3 — — — 6 9 Poliomyelitis — — — 2 2 o — 2 — — — — 8 – Puerperal pyrexia — — — — — — — 1 2 — — — 3 – Scarlet fever — 2 2 10 7 42 0 1 3 — 1 — 74 – Whooping cough 14 14 12 21 17 47 — — — — 1 — 126 2 The number of cases of infectious diseases (including tuberculosis) notified during the year, according to their locality, are shown below:— TABLE X Total Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total Deaths Cerebro-spinal fever 1 — — 1 — — — — Dysentery 6 — 1 — 3 2 — — Erysipelas 5 2 — — 3 — — — Food Poisoning 4 — — — — 3 1 — Measles 194 74 35 5 45 22 13 — Pneumonia 50 0 10 G 12 8 5 33 Polioencephalitis 6 2 — — 1 2 1 2 Poliomyelitis 8 1 1 — 2 4 — – Puerperal pyrexia 3 — — – — 1 — – Scarlet fever 74 13 14 15 15 5 12 – Tuberculosis (all forms) 126 23 19 13 31 23 17 24 Whooping cough 126 60 13 4 25 16 8 2 Total 603 184 93 46 137 86 57 61 23 TABLE XI Age Periods NEW CASES DEATHS Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary Male Female Male Female Male Female Male Female 0-1 - - - - - - - - 1-5 4 4 - - - - - - 5-10 4 3 1 1 — - - — 10-15 3 3 1 1 - - 1 - 15-25 16 13 2 2 1 4 - - 25-35 21 9 1 - 1 5 — - 35-45 13 6 - - 3 1 - - 45-65 7 4 1 — 3 2 — — 65 + 4 2 - — 2 1 — — Totals 72 44 6 4 10 13 1 — TABLE XII The occupations of the new cases are as follows:— Occupations Pulmonary Non-Pulmonary Male Female Male Female Building and decorating trades 4 - - - Schoolchildren 6 6 1 1 Clerical work 15 7 1 2 Domestic duties — 16 — - Industrial workers 21 5 1 — No occupation 12 5 2 — Various 14 5 1 1 Totals 7 2 44 6 4 24 Table XIII Houses, Public Health Act, 1936 5,704 Houses, Housing Act, 1936 84 Overcrowding 296 Disinfestation 190 War Damage 1 Vans, Sheds 150 Shops Acts 284 Pood Shops 729 Pried Pish 31 Cafes, etc. 399 Factories (Mechanical) 111 Factories (Non-Mechanical) 11 Outworkers 40 Food Factories 260 Smoke 357 Offensive Trades 5 Bakehouses 31 Dairies 66 Water Sampling 31 Milk Sampling 52 Other Foods Sampling 152 Schools 15 Stables 54 Accumulations 186 Hairdressers 6 Slaughterhouses 7 Rats and Mice 151 Petrol 104 Canal Boats 14 Infectious Diseases 24 9,545 25 Table XIV Statistics. HOUSING 1. Inspection of dwelling-houses during the year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,851 (b) Number of inspections made for the purpose 5,788 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 - (b) Number of inspections made for the purpose — (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation - (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 838 2 Remedy of defects during the year without service of formal notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the local authority or their officers 601 3. Action under statutory powers during the year:— (a) Proceedings under Sections 9, 10 and 10 of the Housing Act, 1930:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs - (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners — (b) By local authority in default of owners — (b) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 204 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 153 (b) By local authority in default of owners — (c) Proceedings under Sections 11 and 13 of the Housing Act, 1930:— (1) Number of dwelling-houses in respect of which Demolition Orders were made - (2) Number of dwelling-houses demolished in pursuance of Demolition Orders - (d) Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made - (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement room having been rendered fit - 4. Housing Act, 1930 — Overcrowding:— (a) (1) Number of dwellings overcrowded at the end of the year 91 (2) Number of families dwelling therein 134 (3) Number of persons dwelling therein 559 (b) Number of new cases of overcrowding reported during The year 50 (c) (1) Number of cases of overcrowding relieved during the year 70 (2) Number of persons concerned in such cases 298 (d) Particulars of any case in which dwelling-houses have again become overcrowded after The local authority have taken steps for the abatement of overcrowding 1 26 INDEX. Page Antitoxin 9 Area of Borough 6 Atmospheric Pollution 16 Bed bugs 12 Births and birth rate 7, 18, 20, 21 Canal boats 12 Cancer . 9, 22 Carbide 13 Catering establishments . 15 Cattle market 13 Causes of death 19 Celluloid and Cinematograph Film Act 13 Chiropody 11 Deaths and death rates 7, 18 Deaths in wards 19 Diphtheria 10, 19, 20 Disinfection 9 Employees' medical examinations 11 Factories Act, 1937 12 Food inspection 13, 14, 15 Food poisoning 4 Food sampling 14 Health propaganda 11 Houses—number inhabited 6 Housing 13, 26 Infant mortality 8 Infectious diseases, prevalence and control of 8, 9 Inspection and supervision of food 13 Inspection of sanitary accommodation in factories 12 Irradiation experiment 10 Laboratory facilities and work 14 Markets 13 Massage, establishments for 11 Maternal morbidity 8 Maternal mortality 21 Page Medical examinations 11 Meat and other foods 14 Milk licences 13, 14 Milk sampling 14 Mortuary 12 National Assistance Act, S.47 10 Notifiable diseases 10, 23 Old persons in need of care and attention 10 Ophthalmia neonatorum 10 Overcrowding 13, 26 Outworkers 13 Petroleum Acts 13 Physical features of the district 6, 7 Polioencephalitis 7, 9, 10, 19, 20, 23 Poliomyelitis7, 9, 10, 19, 20, 23 Population 6 Premature infants 8 Propaganda—Health 11 Public Health Committee 3 PuerpeTal pyrexia 8, 20 Rats and mice 15 Rateable value 6 Sanitary circumstances 11 Sanitary Inspection 11 Scabies clinic 8 Scarlejc fever 9, 20, 23 Shops Acts 13 Smallpox 9 Social conditions 6 Staf 6 Statistics—General and Vital 6, 7, 18 Statutory action 25 Stillbirths 7, 18 Tuberculosis 10, 19, 23, 24 Unfit houses 26 Verminous persons 8 Vital statistics 18, 20 Water supply and service 11 27